President Barack Obama set a high standard for tribal-federal
relations last year. "Today's summit is not lip service," he said at
the summit. "We're not going to go through the motions and pay tribute
to one another, and then furl up the flags and go our separate ways.
Today´s sessions are part of a lasting conversation that's crucial to
our shared future."

That lasting conversation is continuing as promised. It´s remarkable
enough for a president and cabinet officers to meet with tribal
leaders once during an administration -- but this second round means
that the standard is now an annual event

So what should we be saying about our shared future?

I´d use this as an opportunity to prepare for the coming financial
storm -- serious and long-term budget cuts that are coming from
Congress -- as a way to reconfigure federal services to Indian Country.

Take Medicaid and Children´s health programs. One of the best ideas
coming out of the health care reform process is a feasibility study
exploring the treatment of the Navajo Nation as a state. In tough
budget times this is huge because state governments want to limit
enrollment in Medicaid and Children´s Health Insurance to save money.
But eligible American Indian and Alaska Natives do not cost the states
money -- it´s a 100 percent federal match. By moving the
administration to the Navajo Nation, it makes it much more likely that
eligible patients will be enrolled in Medicaid or Children´s health
adding critical revenue to the Indian health system.

The Navajo Nation feasibility project is only step one. This should be
the beginning of a process that singles out other tribes, or regional
associations, into administrative units that could manage Medicaid
programs without a state roll. Or as I have put it before, treat
Indian Country as a 51st state.

As the federal budget gets tighter and tighter it makes sense to look
for ways to cut administrative costs. A small office directly funding
tribal programs at the Centers for Medicaid and Medicare is a lot more
efficient than distributing money through some 37 state programs when
the end payment eventually goes to either the Indian Health Service or
a tribal contractor anyway. (If pitched smartly, states might even
like this idea.)

The president has done a great job of protecting budgets directed at
Indian Country during his two years in office. But that is going to be
impossible in a Republican-controlled House of Representatives. In
this environment, political rewards will go to those members of
Congress who are the most aggressive, most passionate, most zealous
about a creating a smaller federal government.

That very notion is an opportunity. Tribal governments are smaller and
more efficient than either the federal or state governments and
operate with a workforce that is less expensive both now and in the
future. Just last month the White House announced a two-year freeze on
federal pay. Again the pressure to cut administrative costs is an
opportunity for Indian Country because tribes and other Native
organizations can provide direct services at a lower cost.

Another way to think about that is by comparing pension obligations
from state and federal governments to those of tribal governments.
There is not good comprehensive data, but few tribes have benefits
that are anywhere near as generous as those in state or federal
programs.

President Obama will listen to many ideas at the Tribal Nations
Summit. He´ll probably even get calls to protect federal spending as
it currently stands. That would be a wasted opportunity because future
budgets will be smaller no matter what. My hope is instead a focus on
the practical. What can be done in the current political climate to
the serve American Indian and Alaska Native people? What´s the best
way to effectively manage the resources required? What´s a fair share
when there´s fewer dollars coming from the treasury?

The answers ought to come from a lasting conversation about our shared future.

Mark Trahant is a writer, speaker and Twitter poet. He is a member of the
Shoshone-Bannock Tribes and lives in Fort Hall, Idaho. Trahant’s new book, “The Last Great Battle of the
Indian Wars,” is the story of Sen. Henry Jackson and Forrest Gerard.